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Occupational Diseases
FRIDAY MORNING SESSION
October 9, 1936
The session was called to order by the Chairman, Dr. Hart E. Fisher, Vice-President for Health, National Safety Council,
and Chief Surgeon, Chicago Rapid Transit Co.. Chicago, who presided, introducing The speakers.
The Lesser Known Facts About Common Occupational Diseases
By DR. ROBERT B. HUNT ; Medical Advisor, American Mutual Liability Insurance Co., Boston
Probably the leader in the parade of industrial diseases is an acute or chronic inflammation of the skin which we call dermatitis. This disease may present it self in any t) pe of shop, factory or foun dry. Any paste, powder, gas or liquid which comes in contact with the em ployee's skin, even the water supplied by the town in which he lives or works, may be the potential cause of such a skin disturbance.
The wide diversity of causes together with the varying susceptibility of differ ent individuals makes the problem of control difficult.
Much investigation is under way to determine why one person may be sus ceptible to a certain substance while an other is not. It has been proved many times that a poisonous substance formed within the body has been able to prolong the action started by some external influ ence. A printer developed, a marked dermatitis from ink which persisted for two years. Finally food tests were made and showed that he was susceptible to lettuce, which, when removed from his diet cleared the skin. He returned to his usual occupation without a return of symptoms.
The poisoning of allergic substances is usually an accumulative process. It takes time to produce a manifestation of dis ease, but let any other substance cause the disease, and the irritating food may be of sufficient strength to magnify its action.
All cases of dermatitis cannot be cured by eliminating offending foods, but fur ther investigation along these lines may
give us a clue with which to lessen the loss of time from wrork and the discom fort now produced by industrial derma titis.
Lead
Metals
The distribution of lead poisoning is quite extensive.
The skin of the body is a protective covering, and as long as it remains in tact it docs a good job except ir. the case of tetraethyl lead, W'hich is used in blend ing gasoline and which is readily absorbed through the skin, having a tendency to create changes in the nervous system. The effect of other forms of lead, through that avenue of entrance, is practically nil, which explains the extremely low poisoning rate in typesetters, painters and others who continually come in contact with metallic lead.
Lead in any form, introduced through the mouth, acts rather slowly when com pared with the inhalation of lead dust or fumes. How'ever, no matter what the portal of entry may be, lead is acted upon by the body fluids and so converted that it may eventually be deposited with in the bones.
Those bony safe deposit vaults may retain their lead contents for days or for years, and if the exposure is removed, may also free the employee of all signs
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126 Twenty-fifth National Safety Congress
tilation. Instead, high velocity ventilating apparatus should be installed, functioning as closely to the point of generation of the harmful substance as is possible.
Individual machines should be so equipped if possible. Baffles may be in troduced to prevent air stream disturb ances or to increase the intake efficiency at the nozzle. Down-draft systems should be preferred for the collection of dust or gases of high specific gravity.
Even after the installation of exhaust systems, the engineer must study the type of maintenance required to keep them operating at peak efficiency. Noz zles should not be permitted to become covered nor moved out of proper posi tion. Exhaust piping must be kept dust tight. Blower efficiencies must be con stantly checked to insure that intake ve locities are proper. The best ventilating system is a false protection if it does not function properly or if it is so poorly maintained that it falls below its designed rating. The engineer must exercise ex treme care to provide a clean source of replacement air for the work place. He may find it necessary to install filtering and heating devices. The engineer must study the proper disposal of the collected or expelled material to be positive it will not drift back into the work place.
Employee Protection. While the pri mary engineering means of protection against possible occupational diseases should be mechanical correction, the en gineer will find instances where even the best systems must be supplemented by individual protection. He must carefully study such exposures to provide the high est efficiency of protection, yet obtain a device easy for the operator to wear con tinuously. When the engineer has been successful in obtaining such a device, he must educate workers to use it.
Sanitation. Clean washing facilities and toilets should be provided. Lunch rooms should be not only clean but also well lighted and attractive and should be un der the supervision of the plant physician.
Scientific Tests. Up to this point the engineer has deduced that, an exposure exists, and from accumulated data has devised his means of prevention. How
ever. the engineer interested in ascer taining not only exposure but also effi ciency of control should realize control cannot be fully effective nor the efficiency of any protective device determined with out scientific tests. Assumption, guess work. unscientific procedure or apparatus have no place in an engineering program. The engineer must test each step unless it has been previously proved, carefully cal culating in advance to avoid false protec tion.
He must be familiar with dust counting, air sampling, and chemical analysis tech nique. having such determinations made by established and proper methods. If such tests are beyond the scope of his ability or equipment and if the engineer considers such tests absolutely essential, then his executives should permit him to obtain experts qualified to make such sur veys as his problem may require. The need for an accurate engineering approach to any control measure cannot be over emphasized.
Conclusion. Every engineer realizes control of any industrial disease expo sure is divided, part of such control fall ing within the jurisdiction of the indus trial physician and part within his own engineering province. Medical knowledge is invaluable in the detection of early symptoms and in the administration of suitable preventive treatment. The en gineer should gladly obtain the services of an industrial physician to make a study of the plant, to assist in the classi fication of the hazardous operations and working locations. By such coordination he will speed control of the exposure.
Each individual occupational disease exposure must be studied, analyzed, and controlled individually. While general data may be available upon common ex posures, the solution can be found only in individual treatment. Such exposures cannot be compared to ordinary safety engineering efforts. A 'circular. saw is a circular saw wherever it may be operat ing, but industrial disease exposure varies within plants and certainly varies between different manufacturing establishments, even though they may produce a like product or article.
ADJOURNMENT
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